HIV-associated immune complex glomerulonephritis with "lupus-like" features

Saudi J Kidney Dis Transpl. 2011 Jul;22(4):769-73.

Abstract

Renal structural abnormalities in HIV/AIDS infected patients have been infrequently and incompletely reported in patients from sub-Saharan Africa. We report an immune complex glomerulonephritis with "lupus-like" features in a ten-year-old HIV+ boy who was evaluated at the University Hospital of Kinshasa. The light microscopic examination of the renal biopsy displayed a predominantly membranoproliferative glomerulonephritis with prominent focal segmental necrotizing injury, numerous wire-loops, and a spiky membranous nephropathy. In addition, there were prominent tubular injury, microcysts filled with periodic acid-Schiff (PAS) positive casts, edema and an inflammatory infiltrate of the interstitium, features of a classic HIV-associated nephropathy (HIVAN). Electron microscopy revealed large subendothelial, intra-membranous, subepithelial and mesangial deposits. The combination of these findings, while being consistent with lupus nephritis WHO grade IV/V, the tubulointerstitial HIVAN-like changes and the absence of clinical evidence of lupus disease favored an HIV-associated immune complex glomerulonephritis with "lupus-like features".

Publication types

  • Case Reports

MeSH terms

  • AIDS-Associated Nephropathy / complications*
  • AIDS-Associated Nephropathy / diagnosis
  • AIDS-Associated Nephropathy / immunology
  • Antigen-Antibody Complex / immunology*
  • Biopsy
  • Child
  • Diagnosis, Differential
  • Glomerulonephritis / complications*
  • Glomerulonephritis / immunology
  • Glomerulonephritis / pathology
  • HIV Seropositivity / complications*
  • HIV Seropositivity / immunology
  • HIV Seropositivity / pathology
  • Humans
  • Immune Complex Diseases / complications*
  • Immune Complex Diseases / immunology
  • Immune Complex Diseases / pathology
  • Kidney Glomerulus / ultrastructure*
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Erythematosus, Systemic / pathology
  • Male
  • Microscopy, Electron

Substances

  • Antigen-Antibody Complex